Delayed diagnosis of congenital heart diseases and associated factors in the largest tertiary hospital in Ethiopia.

Background: In Africa alone, 500,000 live newborns are born each year with congenital heart disease (CHD). Sub-Saharan Africa contributes a larger portion of these numbers. The prevalence of delayed diagnosis in Ethiopia is unknown. The aim of this study was to determine the magnitude of delayed diagnosis of CHD and associated factors at Tikur Anbessa Specialized Hospital (TASH). Methods: This study was conducted in TASH at the Department of Pediatrics and Child Health from June 1 to October 30, 2023. TASH is the tertiary and largest hospital in the country, located in the capital city, Ethiopia. An appropriate diagnosis of CHD is usually made after referral to the hospital. A cross-sectional study design was employed. The data were collected via the KoboToolbox and exported to SPSS version 29 for analysis. Descriptive statistics were used to examine participants' sociodemographic, socioeconomic and clinical characteristics. Binary and multivariate logistic regression analyses were used to assess associations between variables. Results: Out of 228 study participants, 121 (53.1%) had a delayed diagnosis of CHD. The majority of patients (n=39, 83%) with cyanotic heart diseases were diagnosed late. The proportion of delayed diagnoses among patients with acyanotic CHDs was 45.4% (n=82). The median age at diagnosis for patients with acyanotic CHD was 6 months [interquartile range (IQR), 1.5-24 months], whereas the median age at diagnosis for patients with cyanotic CHD was 9 months (IQR, 1.5-29 months). The probability of a delayed diagnosis of CHD was 2.34 [95% confidence interval (CI): 1.05-5.25], 4.47 (95% CI: 1.29-17.59), 2.79 (95% CI: 1.49-5.19) and 6.84 (95% CI: 2.86-16.34) times greater respectively for lack of optimal antenatal care (ANC) visits, no obstetric ultrasound, traditional birth attendant and cyanotic CHDs. Conclusions: The magnitude of delayed CHD diagnosis was unacceptably high (53.1%). The factors associated with delayed diagnosis were ANC visits, obstetric ultrasound, type of birth attendant and type of CHD.